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Master Thesis

Remplacement valvulaire mitral chirurgical versus implantation valvulaire mitrale percutanée (TMVI) dans les dégénérescences de bioprothèses mitrales

Abstract : Background: there are few data regarding clinical and echocardiographic outcomes after transcatheter mitral valve-in-valve implantation (TMVI) compared with redo surgical mitral valve replacement (SMVR). Aims: to evaluate the feasibility, safety and short-/mid-term outcomes of TMVI vs. SMVR in degenerated mitral bioprosthesis. Methods: 33 patients who underwent SMVR et 52 TMVI valve-in-valve by transseptal approach, for degenerated mitral bioprosthesis, have been identified retrospectively. A composite outcome has been defined including cardiovascular mortality, stroke, major hemorrhage, hospitalization for heart failure or mitral reintervention. Results: mean age and EuroSCORE II were significantly higher in TMVI group than SMVR group (age 63±21 years vs. 51±15 years, p=0.002; EuroSCORE II 12.5±12.2% vs. 6.2±3.3%, p=0.001). Median follow-up was 2 years. At 5 years, there was no significant difference in survival between TMVI vs. SMVR (61.5±10.5% vs. 81.4±8.7%, p=0.07); event-free survival was significatively lower in TMVI group (34.3±9.8% vs. 78.3±9.1%, p=0.002). At last follow-up, left ventricular ejection fraction was 56±10%, mean mitral valve gradient was 6±3 mmHg. Age, prior tricuspid valve surgery, neurologic history, dialysis and non-elective procedure, were identified as risk factors of poor outcome. Conclusion: TMVI may be an alternative to SMVR in patients at high risk, with degenerated mitral bioprosthetic valves.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03203840
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Thursday, May 6, 2021 - 4:08:05 PM
Last modification on : Tuesday, September 14, 2021 - 9:16:46 AM

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  • HAL Id : dumas-03203840, version 1

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Adeline Fuchs. Remplacement valvulaire mitral chirurgical versus implantation valvulaire mitrale percutanée (TMVI) dans les dégénérescences de bioprothèses mitrales. Médecine humaine et pathologie. 2019. ⟨dumas-03203840⟩

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